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Different mutation patterns of Plasmodium falciparum among patients in Jimma University Hospital, Ethiopia

Ronan Kelly

Retired 2020
Different mutation patterns of Plasmodium falciparum among patients in Jimma University Hospital, Ethiopia


The emergence of drug resistance is a major problem in malaria control. Combination of molecular genotyping and characterization of mutations or single nucleotide polymorphisms (SNPs) correlated with drug resistance can provide information for subsequent surveillance of existing and developing drug resistance patterns.

The introduction of artemether/lumefantrine (AL) as first-line treatment, never used before in Ethiopia, allowed the collection of baseline data of molecular polymorphisms before a selection due to AL could occur.Method97 patients with uncomplicated falciparum malaria were recruited from April to June 2006 and treated with either AL, quinine (Q) or atovaquone/proguanil (AP) in Jimma University Hospital, Ethiopia. Mutations or SNPs associated with resistance to these drugs were analysed by RFLP (pfdhfr, pfmdr1) and sequencing of the target genes (pfcytb, pfserca ).

Results: SNPs previously reported to be associated with resistance to the study drugs were identified in recrudescent and treatment sensitive isolates.

A total of seven recrudescences were obtained. The pfmdr1 N86Y mutation was found in 84.5 % of isolates.

The triple mutation 51I,59R,108N of the pfdhfr gene occured in high frequency (83.3 %) but no pfcytb mutation was detected. Sequencing showed a variety of previously described and new mutations in the pfserca gene.

Conclusion: The prevalence of mutations was in accordance with the expected patterns considering recent drug regiments.

The broad introduction of AL and the cessation of former drug regimens might probably change the current distribution of polymorphisms, possibly leading to decreased sensitivity to AL in future. Continuous surveillance of molecular patterns in this region is, therefore, recommended.

Author: Teferi EshetuNicole Berens-RihaSintayehu FekaduZelalem TadesseRobert GurkovMichael HolscherThomas LoscherIsabel Barreto Miranda
Credits/Source: Malaria Journal 2010, 9:226
http://7thspace.com/headlines/35334...ts_in_jimma_university_hospital_ethiopia.html
 
Re: Different mutation patterns of Plasmodium falciparum among patients in Jimma University Hospital, Ethiopia

Full provisional paper available here;

http://www.malariajournal.com/content/pdf/1475-2875-9-226.pdf

Abstract:

Different mutation patterns of Plasmodium falciparum among patients in Jimma University Hospital, Ethiopia
Teferi Eshetu , Nicole Berens-Riha , Sintayehu Fekadu , Zelalem Tadesse , Robert Gurkov , Michael Holscher , Thomas Loscher and Isabel Barreto Miranda

Malaria Journal 2010, 9:226doi:10.1186/1475-2875-9-226


Published: 7 August 2010

Abstract (provisional)

Background
The emergence of drug resistance is a major problem in malaria control. Combination of molecular genotyping and characterization of mutations or single nucleotide polymorphisms (SNPs) correlated with drug resistance can provide information for subsequent surveillance of existing and developing drug resistance patterns. The introduction of artemether/lumefantrine (AL) as first-line treatment, never used before in Ethiopia, allowed the collection of baseline data of molecular polymorphisms before a selection due to AL could occur.

Method
97 patients with uncomplicated falciparum malaria were recruited from April to June 2006 and treated with either AL, quinine (Q) or atovaquone/proguanil (AP) in Jimma University Hospital, Ethiopia. Mutations or SNPs associated with resistance to these drugs were analysed by RFLP (pfdhfr, pfmdr1) and sequencing of the target genes (pfcytb, pfserca ).

Results
SNPs previously reported to be associated with resistance to the study drugs were identified in recrudescent and treatment sensitive isolates. A total of seven recrudescences were obtained. The pfmdr1 N86Y mutation was found in 84.5 % of isolates. The triple mutation 51I,59R,108N of the pfdhfr gene occured in high frequency (83.3 %) but no pfcytb mutation was detected. Sequencing showed a variety of previously described and new mutations in the pfserca gene.

Conclusion
The prevalence of mutations was in accordance with the expected patterns considering recent drug regiments. The broad introduction of AL and the cessation of former drug regimens might probably change the current distribution of polymorphisms, possibly leading to decreased sensitivity to AL in future. Continuous surveillance of molecular patterns in this region is, therefore, recommended.
http://7thspace.com/headlines/35334...ts_in_jimma_university_hospital_ethiopia.html
 
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